Analyst, Strategic Operations

Jobtailor; Deutschland; Remote; EUR 50.000 - 75.000; Vollzeit

Zusammenfassung

Jobtailor is seeking an IDR Operations professional to prepare, validate, and submit independent dispute resolutions under federal and state rules. You will tailor supporting evidence, review data for accuracy, and resolve discrepancies before submission.

The role involves payer escalations and driving cash collections while tracking outcomes. You will develop SOPs, training materials, and workflow documentation, support vendor management, and maintain IDR reporting and metrics to surface trends

Qualifikationen

• Bachelor’s degree or equivalent in healthcare, business, finance, or economics preferred.
• 0-2 years of work experience; internship, co-op, or coursework in healthcare, finance, analytics, or operations preferred
• Prior experience with multiple systems and platforms
• Experience in a high-growth healthcare company preferred
• Experience with Independent Dispute Resolution under NSA preferred; training provided
• Proven critical thinking and problem-solving skills; able to handle ambiguous problems
• Excel proficiency including pivot tables and VLOOKUP
• Ability to work independently and manage competing priorities with limited supervision
• High attention to detail and strong organizational skills
• Effective written and verbal communication with internal teams and external payer parties
• Negotiation and conflict-resolution skills to advocate for claim approvals
• Ability to interpret payer policies and state/federal regulations
• Proficiency with Microsoft Office Suite
• Familiarity with HIPAA and confidentiality
• Interest in learning a complex regulatory area

Aufgaben

• Prepare, validate, and submit Independent Dispute Resolution disputes under federal and state requirements
• Confirm dispute eligibility and customize supporting evidence for each dispute
• Review claim, payer, and determination data for accuracy and completeness
• Resolve discrepancies before submission
• Facilitate payer escalations and drive cash collections on prior disputes through phone, written, and faxed follow-up
• Track payment status through resolution
• Develop SOPs, training materials, and workflow documentation for escalation and collection activity
• Support vendor management by organizing documentation and tracking deliverables
• Develop and maintain reporting and metrics for the IDR program
• Surface trends in eligibility, determinations, payer behavior, and recovery
• Translate analytical results for non-technical audiences and executive management
• Maintain knowledge of payer guidelines, state/federal regulations, and industry standards
• Collaborate with payers during disputes to reach resolutions and improve relations
• Resolve data integrity and integration issues across departments
• Identify process, documentation, and tooling improvements and own improvement projects
• Perform other duties as assigned
• Report to the Vice President of Strategic Operations (IDR)

Kenntnisse

Excel proficiency

Data analysis

Reporting and metrics

Payer policy interpretation

Process improvement

Critical thinking

Problem-solving

Attention to detail

Time management

Workflow documentation

Effective communication

Organizational skills

Ability to work independently

Collaboration

Adaptability

Ausbildung

Bachelor’s Degree in Healthcare Administration, Business, Finance, Economics or similar

Tools

Salesforce

Tableau

Pivot Tables

VLOOKUP

Microsoft Office Suite

Jobbeschreibung

• Prepare, validate, and submit Independent Dispute Resolution disputes under federal and state requirements


• Confirm dispute eligibility and customize supporting evidence for each dispute


• Review claim, payer, and determination data for accuracy and completeness


• Resolve discrepancies before submission


• Facilitate payer escalations and drive cash collections on prior disputes through phone, written, and faxed follow-up


• Track payment status through resolution


• Develop standard operating procedures, training materials, and workflow documentation for escalation and collection activity


• Support vendor management by organizing documentation, coordinating contract and information requests, tracking deliverables, and monitoring vendor performance


• Develop and maintain reporting and metrics for the IDR program


• Surface trends in eligibility, determinations, payer behavior, and recovery


• Translate analytical results for non-technical audiences, executive management, and external partners


• Maintain knowledge of payer guidelines, state/federal regulations, and industry standards


• Collaborate with payers during disputes to reach mutually beneficial resolutions and improve payer relations


• Resolve data integrity and integration issues across departments


• Identify process, documentation, and tooling improvements and own assigned improvement projects


• Perform other duties as assigned


• Report to the Vice President of Strategic Operations (IDR)

Requirements

• Bachelor’s Degree in Healthcare Administration, Business, Finance, Economics or similar is preferred


• 0-2 years of work experience; internship, co-op, or coursework in healthcare, finance, analytics, or operations preferred


• Prior experience working with multiple systems and platforms


• Experience in a high-growth healthcare company preferred


• Experience with the Independent Dispute Resolution process under the NSA preferred; training will be provided


• Proven critical thinking and problem-solving skills, including working through ambiguous or undefined problems and recommending a course of action


• Excel proficiency, including pivot tables and VLOOKUP, and comfort working with large datasets


• Ability to work independently, manage competing priorities, and follow through on long-running items with limited direct supervision


• High attention to detail and excellent organizational skills


• Effective written and verbal communication with internal teams and external payer parties


• Negotiation and conflict-resolution skills to advocate for claim approvals


• Ability to interpret and apply payer policies, state/federal regulations, and compliance standards


• Proficiency in time management for high-volume workloads


• Ability to work effectively under deadlines and self-manage multiple projects simultaneously


• Experience with Salesforce preferred; exposure to Tableau or similar visualization tools a plus


• Proficiency with Microsoft Office Suite or related software


• Familiarity with healthcare compliance standards such as HIPAA and ability to maintain confidentiality


• Interest in learning a complex and rapidly evolving regulatory area


• Ability to thrive in a high-growth, fast-paced organization and 100% remote-based environment


• Must be able to remain in a stationary position 50% of the time

Core Competencies

Demonstrates expertise in Independent Dispute Resolution processes, payer guidelines, and healthcare compliance standards while effectively managing multiple projects and priorities in a fast-paced environment. Proficient in data analysis, reporting, and communication to facilitate dispute resolutions and improve payer relations.

Highest-signal resume keywords

• Independent Dispute Resolution Process


• Excel Proficiency


• Healthcare Compliance Standards


• Negotiation and Conflict-Resolution Skills


• Data Analysis and Reporting

Hard Skills

• Data Analysis


• Reporting and Metrics Development


• Payer Policy Interpretation


• Process Improvement


• Critical Thinking


• Problem-Solving


• Attention to Detail


• Time Management


• Workflow Documentation


• High-Volume Workload Management

Soft Skills

• Effective Communication


• Organizational Skills


• Ability to Work Independently


• Collaboration


• Adaptability

Industry Keywords

• Healthcare Administration


• Payer Relations


• State/Federal Regulations


• HIPAA Compliance


• High-Growth Healthcare Company

Tools & Technologies

• Salesforce


• Microsoft Office Suite


• Tableau


• VLOOKUP


• Pivot Tables